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1877-0428 © 2016 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license
(http://creativecommons.org/licenses/by-nc-nd/4.0/).
Peer-review under responsibility of the organizing committee of ISTH2020
doi: 10.1016/j.sbspro.2016.05.380
2nd International Symposium "NEW METROPOLITAN PERSPECTIVES" - Strategic planning,
spatial planning, economic programs and decision support tools, through the implementation of
Horizon/Europe2020. ISTH2020, Reggio Calabria (Italy), 18-20 May 2016
The Mediterranean Diet from Ancel Keys to the UNESCO
Cultural Heritage. A Pattern of Sustainable Development
between Myth and Reality
Elisabetta Moroa,*
aUniversity of Naples Suor Orsola Benincasa, via Suor Orsola 10, 80135 Napoli, Italy
Abstract
This paper deals with the Mediterranean Diet as a potential tool for increasing knowledge and promoting a
sustainable development especially in least developed and developing regions. The confirmation of the MD as an
Intangible Heritage of Humanity, recognized by UNESCO in 2010, is producing a significant social effect in the
seven nations and communities involved. In addition in 2012 the MD has been included by the FAO at the top of the
list of the most sustainable diets in the planet. The double recognition of this life style is generating a new approach
to this cultural heritage by the stakeholders who are progressively recognizing that it may become a new tool to
develop green economy and eco-tourism. To this end the author analyses the real and mythological genealogy of the
MD in order to bring out its cultural, economic and social potentiality.
© 2016 The Authors. Published by Elsevier Ltd.
Peer-review under responsibility of the organizing committee of ISTH2020.
Keywords: Mediterranean Diet; ancel keys; UNESCO; cultural heritage; sustainable development.
* Corresponding author. Tel.: +0-081-252-2372.
E-mail address: elisabetta.moro@unisob.na.it
© 2016 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license
(http://creativecommons.org/licenses/by-nc-nd/4.0/).
Peer-review under responsibility of the organizing committee of ISTH2020
656 Elisabetta Moro / Procedia - Social and Behavioral Sciences 223 ( 2016 ) 655 – 661
The confirmation of the Mediterranean Diet as an Intangible Heritage of Humanity recognized by UNESCO in
2010 is producing a very strong social effect in the nations involved, but also in the UNESCO Communities
concerned by this political, cultural and social process, such as Cilento in Italy, Koroni/Coroni in Greece, Agros in
Cyprus, Brač and Hvar in Croatia, Soria in Spain, Chefchaouen in Morocco and Tavira in Portugal. In addition in
2012 the Mediterranean Diet (MD) has also been included by the FAO inside the group of the most sustainable diets
on the planet (Burlingame & Dernini, 2012; Petrillo, 2012: 225; Dernini & Berry, 2015). This double recognition
has generated a new approach to this heritage that is increasingly relevant for the green economies and for the
development of many territories that are far from mass tourism or large scale agriculture. In order to understand the
potential of this anthropological heritage it is first necessary to clarify what the MD is and how this cultural
patternhas been discovered and theorized, in other words the process that has produced the identification of this
specific deposit of culture and the stakeholders involved.
First of all it is important to realize that the aim of the UNESCO recognition has not been the nutritional pyramid,
with its ideal proportions between carbohydrates, proteins and fats. The aim is not even the specific products used in
the Mediterranean cuisine, like tomatoes, olive oil, grains and wine, and much less pasta and pizza, even if those
foods are two planetary successes of the Italian traditional cooking and two great representatives of the MD.
Instead, what UNESCO officially recognized was that “The Mediterranean diet constitutes a set of skills,
knowledge, practices and traditions ranging from the landscape to the table” (Petrillo, 2012: 224). As a matter of
fact what UNESCO recognized was the anthropological pattern concerning the culture of food that all the
communities we mentioned have created, invented and transmitted for centuries. Rhetorics, and social policies have
transformed simple food as a symbolic operator, a community factor, a marker of identity. What they created is a
unique way to use food as a tool in order to build a community habitat. Eating together and food traditions in this
geographic area are elements of an alimentary code that transforms the table in a metaphoric field in which the koiné
(community) is constantly built and re-built (Detienne, 1972; Detienne & Vernant, 1977; Braudel, 1985; Niola, 2015;
Teti, 2015).
Following is the definition of this cultural heritage written in the UNESCO Nomination File
1
by its stakeholders
(the seven communities, with the aid of their national governments):
«The Mediterranean Diet – derived from the Greek word díaita, way of life – is the set of skills, knowledge,
rituals, symbols and traditions, ranging from the landscape to the table, which in the Mediterranean basin concerns
the crops, harvesting, picking, fishing, animal husbandry, conservation, processing, cooking, and particularly
sharing and consuming the cuisine. It is at the table that the spoken word plays a major role in describing,
transmitting, enjoying and celebrating the element. Served for millennia, the Mediterranean Diet, the fruit of
constant sharing nourished as much by internal synergies as by external contributions, a crucible of traditions,
innovations and creativity, expresses the way of life of the basin communities, particularly those of the seven States
Parties submitting this nomination and more precisely that of the communities of Agros, Brač and Hvar, Soria,
Koroni/Coroni, Cilento, Chefchaouen and Tavira.
With regard to its utilitarian, symbolic, and artistic popular expressions, it is important to highlight the
craftsmanship and production of ancestral domestic objects linked to the Mediterranean Diet and still present in
everyday objects, such as receptacles for the transport, preservation and consumption of food, including ceramic
plates and glasses, among others. As a unique lifestyle determined by the Mediterranean climate and region, the
Mediterranean Diet also appears in the cultural spaces, festivals and celebrations associated with it. These spaces
and events become the receptacle of gestures of mutual recognition and respect, of hospitality, neighbourliness,
conviviality, intergenerational transmission and intercultural dialogue. They are opportunities to both share the
present and establish the future. These communities thus rebuild their sense of identity, belonging and continuity,
enabling them to recognise this element as an essential component of their common and shared intangible cultural
heritage»
2
.
1
Nomination file no. 00884 for Inscription in 2013 on the Representative List of the Intangible Cultural Heritage of Humanity approved in Baku,
Azerbaijan in December 2013 and Nomination file no. 00394 for Inscription on the Representative List of the Intangible Cultural Heritage of
Humanity approved in Nairobi, Kenya in November 2010 in http://www.unisob.na.it/ateneo/c002_i.htm?vr=1:.
2
www.unesco.org
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Elisabetta Moro / Procedia - Social and Behavioral Sciences 223 ( 2016 ) 655 – 661
It is quite significant that the MD received the UNESCO imprimatur the first in the history - together with the
Repas gastronomiques des Français – because food was not considered until then a cultural heritage by this
prestigious institution. But in recent years something has changed in public and institutional opinion. The MD is the
litmus test of the birth of a new symbolic common sense that makes food the signal of a planetary transformation of
attitudes, feelings and collective responsibility towards nature and living species. Into this new cultural landscape is
inserted the MD, which is the resultant of different local food cultures and at the same time a global intellectual
product. In fact the UNESCO Mediterranean Diet is not just the result of an acknowledgment of the existence of
something but also the outcome of a crossing of heteroclite glances, that since the fifties, has progressively
identified, created and idealized a real form of life. Diaìta.
Not surprisingly, for the Ancient Greeks the MD meant rule of life, life style, but also home, habitat and research
(Moro, 2014: 16). And the genuine simplicity of olive oil, bread and wine, sacred elements of the Mediterranean
civilization, becomes the symbol of a modern frugal abundance. That is the new recipe theorized by many
intellectuals who looking back to the past may be a return to the future (Latouche, 2000; 2004). And nutrition is one
of the key elements in this new model of society, simply because food has always been the real gasoline of human
history, the material energy of bodies, brains, societies, ideas and emotions. War and peace depend on food more
than on anything else. One common error is the belief that poverty and necessity have mostly determined what
people eat and cook, and also that old traditions were all born by poverty. This is just partially true. All cultures
choose what to eat, why and when, through a collective and quite sophisticated cultural process, in which necessity
is just one possible explanation (Sahlins, 1972; Douglas, 1966).
This general anthropological rule also works for the MD, which today I would define a cultural pattern (Benedict,
1934), to give the sense of a unity of institutions, ideas and traditions that, connected one another, create what we
usually call a culture. The MD in the larger sense of a life style is the effect of the interaction of several institutions,
ideas, and traditions, which co-operated for centuries in a specific geographical area. It is a certain way of farming,
nourishing, feasting, praying: producing goods and worshipping gods.
Professor Jeremiah Stamler, emeritus of the University of the Northwestern University of Chicago, one of the
international stars of cardiology and promoter of the MD as a lifestyle capable to prevent the cardio vascular
diseases, is a special witness and stakeholder of this political, medical, and cultural process. It is relevant to know
also that he has been a colleague of Ancel Keys, the discoverer of the MD and inventor of its name (Moro, 2014: 37-
41). With Keys, Stamler spent part of each year living in the small village of Pioppi/Pollica in Cilento, becoming in
more than 40 years of attending there, a citizen. When Stamler wrote a letter to the UNESCO Commission in favor
of the candidature of the MD he also pointed out the cultural pattern behind it, and he defined it as a social practice
rather than a clinical nutritional system:
«The Mediterranean Diet is for us a shared heritage of value for our well-being, handed down from one
generation to the next, uniting social classes, and bringing families and friends together to share common moments
of delectable and healthful pleasure (…).
I am, for these reasons, convinced that the registration of the Mediterranean Diet in the prestigious UNESCO List
would represent for our community a further guarantee of the safeguard of this tradition and, at the same time, it can
strengthen the UNESCO List that therefore can be perceived by many people as the ideal place acknowledging
traditions that unite and enhance countries, cultures, religions, and community histories that are seemingly different
(Signed: Professor Jeremiah Stamler M.D. President of the Association for the Mediterranean Diet – Pioppi/Pollica
Cilento)»
3
.
During my research on the MD spanning one decade, I noticed that the MD is also an invention, in the Latin
sense of the word invenire, which means to discover, to recognize, to find. It is the result of a foreign look that has
recognized a coherent and healthy system of living and feeding, which could not be seen by the natives, who as a
matter of fact, did not have a specific name for it. Again, the name and concept of the MD was invented by
Americans Ancel Keys, a physiologist at the University of Minnesota (and inventor of the United States Army’s K-
Ration) and Margaret Haney, his wife and a biologist of the Mayo Foundation (Moro, 2014; Dixon, 2015).
3
This Letter by Jeremiah Stamler is part of the dossier that the Italian Ministry of Agriculture has attached to the dossier of candidature. Another
interesting case of a process of identification, definition and collective construction of a Cultural Heritage fitting into the UNESCO interpretative
grid is the Val di Noto in Sicily, studied by Berardino Palumbo (Palumbo, 2011).
658 Elisabetta Moro / Procedia - Social and Behavioral Sciences 223 ( 2016 ) 655 – 661
In 1951 Ancel Keys was invited to the first FAO Congress after the end of World War II, and during his lecture
he explained that in USA 50% of males from the age of 39 to 59 were condemned to die having a heart attack, and
nobody could explain why. None of his colleagues made a comment, except for a doctor of the University Hospital
of Naples. His name was Gino Bergami. As Ancel Keys writes on his private memories Adventures of a Medical
Scientist, that I analyzed during my research and put in evidence in my book (Moro, 2014) Professor Bergami told
him that the cardiovascular diseases where not present in his hospital. He also did not know why, but maybe it
would have been useful to investigate in that direction. Keys went back to England, where he was spending a
sabbatical year in Oxford University and he kept thinking about what Professor Bergami had told him. He sent a
telegram to Professor Bergami saying that he had been impressed by his observation. Professor Bergami answered
with another telegram saying: “Why don’t you come to Naples and check yourself?”. Keys answered with this
telegraphic sentence: “We are arriving”. The plural is important; his wife was going to join him. He bought a car, a
Hillman Saloon, and in 4 days they reached the city of the Vesuvius. I have interviewed professor Mario Mancini,
an 80 year old professor, who at that time was just 20 and brought the Keys to the hospital and translated for them
all the medical records. It was true. No heart attacks for the people of that region (Keys, 1999: 43-44, 1995: 1322S;
Moro, 2014: 25-26).
In one month Margaret Haney collected many blood samples of the workers of a famous Neapolitan steelworks
factory and she analyzed them. Comparing them with the samples of the men in Minnesota, they noticed that the
cholesterol rates were greatly different. At that point they had a flash of inspiration. Probably cholesterol was the
causation of heart attacks. But that was not all. They started observing what workers ate, and the first evidence was
that they eat meat once a week, on Sunday evening. It was the meat of a traditional sauce for pasta, called ragout,
that was, and still is, mandatory on Sunday lunch when the families gathers around the table (Moro, 2014: 25-26).
The Keys started to take note of what common people ate: lots of vegetables, legumes, broccoli, all kinds of
fruits, unrefined cereals, dairy products, but very little fish and meat. Neapolitans loved soups, minestre and
minestroni, in Italian. Not the same thing as what French people usually call soups, since they were not made with
cream or butter, but with vegetables, olive oil, and a bit of pasta. The Keys found bean soup, pumpkin soup, green
peas soup, zucchini soup. Those who could afford pasta, would add few spoons of the so called short pasta, not long
spaghetti, but small size pasta. If pasta was not available, they used rice, hard bread or the so called biscotto or
fresella – a whole meal bread, cooked twice in order to make it very dry, so it may be conserved for long periods.
Ancel and Margret arrived soon at the conclusion that probably food was the key factor. Thus Keys’ intuition gave
the birth to a major international research project called Seven Countries Study (Keys, 1994; Kromouth et al., 1993).
That study began with a pilot study in the small village of Nicotera, in the southern Italian region of Calabria, where
the methodology was first tested on the local male population. The results where consistent with the Neapolitan
ones, and today this experiment is the reason of the local vindication of a primacy in the genealogy of the MD. If the
Calabria’s claim of an exclusive primogeniture from an historical point of view would not be correct, on the other
hand this initial study could be the reason for a legitimate ambition to use the MD UNESCO as an instrument for a
new perspective of development of the territory (Piotrowski, Arezki & Cherif, 2009; Prud’homme, 2013; Mazanec
et al., 2007). In a recent article Jeremiah Stamler suggested that in order to improve the public health the MD, in the
version studied in Nicotera and in other Mediterranean places in the 1950s, indeed in Naples, with few corrections,
should be adopted by everybody (Stamler, 2013). Stamler defined this nutritional pattern the MD for the 21st
century. And during an interview with me on 30th January 2014 in Pioppi, he told me:
«If you look at the papers that described the classical Mediterranean Diet, you will find that it was high in salt,
for many man it was high in wine, it was high in oils - which are very caloric - it was perhaps not as high in protein
as one might like, protein from low fat and fat free dairy products, protein from fish, protein from vegetable
products, fagioli, pasta e fagioli etc. I did not myself do research on the Mediterranean Diet, Keys did a lot of
research and I followed closely what Keys was doing, I kept informed and learned from him. Later, when I
commented, I recommended what I call The Modern Mediterranean Diet. Eating style, modified from the “classical”
diet people followed in places like Nicotera (Calabria), studied forty or fifty years ago. That means: not just low
saturated fat and low cholesterol intakes, to avoid high blood cholesterol, also low salt, not too much alcohol to
avoid high blood pressure, not too much oil, control calories, prevent obesity»
4
.
4
http://www.unisob.na.it/ateneo/galleria.asp?vr=1&idev=44
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Elisabetta Moro / Procedia - Social and Behavioral Sciences 223 ( 2016 ) 655 – 661
Many other investigations have been done by the Keys’ research group, and by many other researchers that
brought the OMS to disseminate the Food Guide Pyramid, originally created by the Old Ways Association (Moro,
2014: 28-36; Willett, Sacks, Trichopoulou, Trichopoulos et all., 1995). All those researches, one for all those
conducted in Greece and in Europe by Antonia Trichopoulou (2012, 2009, 2007; Nestle, 1995), have completely
confirmed the initial hypothesis formulated in Naples in 1951 (Mancini & Stamler, 2004). Poor Neapolitan workers
eat healthier than rich American managers, a paradox that few people were ready to accept in a world still very
deeply influenced by the indigence and the malnutrition of World War II.
In 1959 Ancel and Margaret Keys published Eat Well and Stay Well, which immediately became a best seller in
USA. The success of this book was so great that in 1961 Ancel Keys’ gentle and genius face was on the cover of the
Time Magazine (Moro, 2014: 61-65). Few years later the Keys published another book, The Benevolent Bean
(1967), in which this emblematic protein for poor people was presented as a panacea for poor health; a cure for
everything; healthy, light, and nourishing. This diet was also presented as ecologically correct, because it has no bad
impact on the environment (Moro, 2014: 37-38, 48-49). Considering all that, the Keys demonstrated that they had an
extremely advanced position concerning the strict relationship that goes from men to earth, from the health of people
to the healthiness of the globe. And now the FAO
5
tells us that they were absolutely right (Moro, 2014: 17;
Burlingame & Dernini, 2012).
In 1963, when Ancel Keys and Margaret Haney, went into retirement, they decided to move to Italy and
discovered that many things had changed, and not necessarily for the better. The Neapolitans, having become richer,
had changed their habits. Essentially, they had started eating too much. Too many sweets. And in many cases they
had added to the traditional food the industrial packaged foods. These two elements together caused several
alimentary diseases, including diabetes, obesity, and high cholesterol levels in the blood, a phenomenon quite
common also in the rest of the countries in the northern coast of the Mediterranean see (Alexandratos, 2006). But
fortunately, or unfortunately, in Cilento the old alimentary model was still alive, essentially because there had been
no economic growth and the process of industrialization did not arrive over there. The Keys had the sensation that a
paradise was still there and could be discovered. So, first of all, they bought a little hill and they built a house, and
all around them some international scientists did the same, creating a sort of community, a Bloomsbury of Cilento,
that was named Minnelea, from Minneapolis and Elea, a blending of the names of the north American city where
they worked and the ancient city where Parmenides and Zenone gave birth to the western philosophy with the
Eleatic school (Moro, 2014: 44, 118).
Ancel and Margaret lived in Minnelea for 35 years, until 2004, and during all that time they wanted to learn from
common people how to cook in a healthy way. Their very special teacher was Delia, the cook
6
. They made
ethnographic research on food, recording interviews with housewives, fishermen and peasants. And all this
documentation inspired their third book, titled How to Eat Well and Stay Well. The Mediterranean Way, published
in USA in 1975. For the first time the greater public read the expression Mediterranean Diet, invented by them with
the proposal of contrasting the fashion of weight loss diets (Moro, 2014: 44, 118). The scientific Journals had to wait
until 1985 with an article written by Mario Mancini and Anna Ferro Luzzi (Ferro Luzzi & Mancini, 1985).
The manor of the Keys, surrounded by fruit trees, supplied by two organic orchards and one glasshouse, was a
very chic family farm, where the agriculture of proximity, the organic vegetables, food localism, and many other
food mantra were practiced fifty years in advance of the Slow Food movement (Niola, 2015). What the Keys
experienced there was essentially an idea of time, linked to the four seasons, which follow each other, a cycle that
influences also food traditions and gastronomic rites such as Christmas eve supper, Easter lunch, name day feast,
5
F.A.O. has defined the Mediterranean Diet a model of sustainability for the planet. For these reasons:
1. Great diversity that ensures food nutritional quality of diet and biodiversity
2. Variety of food practices and food preparation techniques
3. Main foodstuffs demonstrated as beneficial to health: olive oil, fish, fruits and vegetable, pulses, fermented milk, spices…
4. Strong commitment to culture and traditions
5. Respect for human nature and seasonality
6. diversity of landscapes that contribute to the welfare
7. less demanding food in primary energy and having in priori less environmental impact, due to low consumption of animal
products
6
http://www.unisob.na.it/ateneo/galleria.asp?vr=1&idev=56
660 Elisabetta Moro / Procedia - Social and Behavioral Sciences 223 ( 2016 ) 655 – 661
wedding lunch, birthdays, new year's eve dinner, and so on, each time with the same menu, inherited from the
family or from the community.
Southern Italians love to keep up with their traditions, while many other peoples tend to break with traditions
more easily. This happens because most people in the south still cook every day and each Sunday they spend from
three to five hours eating traditional dishes at their parents’ home, even if married. If the Anglo-Saxon and Puritan
cultures do not assign a strong symbolic or social sense to food, in the Catholic and Islamic people living in the
Mediterranean area food has a crucial significance. For them food plays a very important role in their life. That is
also the reason why when Southern Italians talk of the Mediterranean triad (olives, grains, grapes), they go back to
the ancient Greek religion looking for deep and ancestral meanings: Demeter the goddess of agriculture, Athena the
goddess who gave the gift of olive tree, and Dionysus the god of grapes and wine. And even if they are no longer
worshipped these ideal figures still play a central role in the process of identity construction and in the marketing
strategies.
Identity is never a question of truth, but of emotion. We all are persuadable of a past that provokes a certain
emotion in ourselves. That is why people constantly write their history. And even when they are sincerely convinced
that they are simply recording what really happens, they are any ways observing reality from one particular point of
view, even more so when there is a distance of centuries which makes historical reconstructions extremely difficult,
and in any case influenced by present questions. As shown by many anthropologists in the past history people
always look for something that might be significant for the present.
So why do Italian people love to imagine and tell that the Mediterranean Diet is a gift of Greek gods and not for
example something that has to do with a geographical habitat? Even if they know that nature is a part of the
question, they look for a poetic and mythic explanation of their traditions (Moro, 2014: 98-106). So all though today
many of them no longer follow the traditional MD and they have experienced a complete food transition toward the
Western Diet, they still produce a symbolic value around it, sometimes just to fascinate tourists or to sell food
products. We may say that in any southern Italian there is a potential storyteller of the MD. And this is a great
advantage for a new project of development based on it.
Claude Lévi-Strauss (1962) used to say that mythology plays a great role in all cultures, because it is like a bridge
that men construct to reach a sense, a meaning that stays on the other side of the river. Somehow, Ancel and
Margaret Keys tried to build a bridge. Between the advanced medical investigation and the philosophy of life of a
population. They appreciated the poetic character of the people they met in Cilento, and they spent hours listening to
them because they wanted to learn, from those “primitive” farmers, how to cook and behave in order to reach the
promised Land of Longevity, a very modern myth (Moro, 2014: 159-162) that fascinates an increasing number of
people. In this sense the MD is a model of lifestyle, an educational pattern, a unique heritage that many people will
probably want to learn in the next years. And a very farsighted economic development could profit of this both
immaterial and material demand, making the most out of the common capability to create narrations out of food and
culinary traditions relying on the fact that there is a very high longevity rate in Italian regions such as Cilento,
Calabria, and Sardinia, much higher than in the rest of the World, comparable only with some areas in Japan, and 4
years longer than in the USA. Besides it is higher than in other parts of Italy. As a matter of fact in Cilento presently
women tend to reach the age of 88, while the average in Italy is 84, and men the age of 83 despite the Italian average
of 79. And this is a record better than any advertisement if correctly used in a cultural marketing plan.
The Keys experienced the positive effect of the local lifestyle themselves. In fact they reached a considerable age.
Margaret died when she was 97 years old, and Ancel when he was over a hundred years old. This result is not
attributable to genetic factors, since they were not blood relatives, but most probably to the role played by their
lifestyle (Moro, 2014: 149-150). A Mediterranean Way.
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